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Friday, May 18, 2007

There's a LOT of buzz running right now in the lactivist world about an op-ed piece in the New York Times. The editorial talks about the recent New York City decision to go "baby-friendly" and to keep hospitals from sending ALL moms home with the obligatory black bag from Similac of Enfamil. It's no surprise to hear that not everyone supports the decision, but the post gets an absolute BASIC fact completely and utterly wrong.

(Now, I want to preface this by reminding new readers that The Lactivist is NOT about formula bashing. In fact, if you want to bash formula or moms that use it, I suggest you go elsewhere. This site supports breastfeeding by uplifting nursing moms, not by tearing down formula feeding ones. So let's address this issue with that in mind please and avoid any comments about the author's choice to formula feed.)

Take this quote from the story:

By Day 4 in the hospital, I was a wreck from the pain of the C-section and from trying to nurse with cracked, bleeding nipples that weren't producing milk. The nurses were encouraging and patient with my attempts to breast-feed, but I ultimately decided to bottle-feed my daughter.

The formula samples were a godsend. As a first-time mom who was intending to breast-feed, I had not thought to have formula waiting at home. The perfectly measured samples got us through the first sleepless days until we could get our acts together to buy formula.

Now, I don't know about the rest of you, but even in the "first sleepless days" of motherhood, I could have found a way to run to CVS to buy formula if I'd needed it. (And I live in a village of 3500 people...not in "the city that never sleeps.")

With Caesarean rates skyrocketing in New York City (some hospitals have a nearly 40 percent rate of Caesarean delivery), formula often becomes a necessary part of the equation.

It bothers me that she seems to assume that c-sections and formula must go hand in hand. Granted, there are much higher formula feeding rates for moms that have c-section for a wide variety of reasons...but a c-section in no way makes formula NECESSARY.

Whether bottle-feeding is voluntary or has been dictated by circumstance, neither the government nor the medical establishment should try to manipulate a woman's decision by withholding samples that formula manufacturers are more than happy to provide.

Umm... I agree. The medical establishment should not try to manipulate a woman's decision. Unfortunately, that's exactly what happens when doctors and nurses hand mom a bag of formula and says "Brand X is the best formula" all while watching mom sit there with baby happily nursing away.

Hospitals and government alike should support a mother’s right to decide what is best for her and her child, be it breast-feeding or bottle-feeding. So go ahead, give out the free formula samples: it’s a nice gift, especially on Mother’s Day.

Just. Doesn't. Get. It.

So with that, let me clarify one very important point.

Mothers that give birth in New York City hospitals can still go home with free formula. They simply have to request it now. (There's also no shortage of free formula to be had from OBs, Peds and company web sites.) It annoys me to continue to read about opposition to the "ban the bags" campaigns that focus on the NEED for free formula. Great, take your free formula, but don't send it home with the moms that don't ask for it.

I agree with you on not sending it home to the moms who ask for it! I was given a bag and I was intent on bfing. Not only for the benefits, but in no way could I afford to formula feed! Sometime in the first week I was really tempted by those itty bity bottles... and the next day I threw them out. I refused to give up on bfing because I was a bit uncomfortable! (I am in CA) I just wish they could have gone to a mom who could/would use them.. instead of in the trash. :o(

UGGGHHHHHHHHH! These arguments drive me bat@#$$#. Free formula isn't a "gift" given with compassion, generosity, or some other sort of warm fuzzy desire to help out new moms.

It is marketing.

The Government and The Medical Establishment are not stepping in and forbidding Aunt Bertha from knitting a pair of booties for the little cherub for cryin' out loud.

How can a sane person argue that they are smart and confident enough to make the decision to breastfeed or formula feed on their own without any meddling, but at the same time cannot gather up the smarts to put their hands on a little RTF formula all by their lonesome.

I've always suspected that those who argued for the freebie bags were longing for the validation they brought to their situation: formula feeding is just fine, otherwise why would my doctor/hospital give this stuff to me!

I hope that is not perceived as bashing (heck, we formula fed!), but I seriously have no other explanation. Nobody is "banning the bags." They are available upon request. The only change is that the bags are not presented to all mothers, thus taking one little stab at the ubiquitous of formula in our culture.

Yeah I have a lot of problems with that logic too. As for "trying to manipulate a woman's decision by withholding samples that formula manufacturers are more than happy to provide", you can use that logic for many things. I'm sure there are tobacco manufacturers that would be more than happy to provide cigarette samples to teenagers, but there's a reason why they can't.

Plus, if the woman can simply request the formula to get the free samples, then the whole point is moot. What are they arguing about - that the samples not being shoved in your face is a bad thing?

I know first hand how having those samples so readily available can affect you. I was having a ton of problems breastfeeding in the hospital, and the formula being right in front of me plastered with advertisements about how great it is for the baby almost made me switch. Don't even get me started on the formula advertising. I think there should be regulations about it, just like they have them on tobacco ads. They should be required to state that breast milk is best for the baby, because unless someone does the research on their own and trusts those ads, they really make you believe that you're doing the best for your baby by giving him formula. Arrrg.

I do not have any children (although we're currently trying), so I can't speak from experience, but I do have to say that I can see both sides of the argument. I read a post recently (it may have been one of yours), that said nurses get kickbacks for saying "this formula is the best". I thought that was awful and should not be allowed in hospitals of all places. Many people trust everything that doctors/nurses tell them, and for a mother who has never breastfed before, a nurse telling them that such-and-such formula is the best may be the thing that sends the mother to using formula. While I do not think formula is evil, I do think mothers should be encouraged as much as possible to breastfeed if they are able to. So I do like the fact that the bags will no longer be given to mothers unless they ask.

However, to argue the other side, for those mothers who do not have a support system, who do not have anyone to help them at home, that free formula may be very helpful for them in those first few days after birth, especially if they find they are unable to breastfeed. My hope is that the hospitals make mothers aware that the free formula is available to them, and that mothers are not made to feel guilty for asking for the bags.

After reading the entire article I too can see that this woman doesn't get the point. I never thought that the ban the bags campaign was about refusing to give any mother formula. I thought that it meant they had to ask, if they'd already decided to breastfeed.

Now, I'm not trying to sound rude here...but it is -not- the responsibility of the hospital or it's staff to provide new parents with anything. This would include diapers, wipes, formula, baby shampoos etc. All their job is, is to deliver a baby and make sure everything is in working order.

I think that's what made me so irritated about the article. This woman had a sense of entitlement in her tone.

You can't drive yourself home from the hospital after a vaginal delivery, let alone a c-sec. How about have your driver stop at a grocery store or any other place that sells formula and pick up a couple of cans.

With my first child I was on WIC and they helped me out with the paperwork in the hospital so that I could get my vouchers as soon as I got home. I sent my husband to pick them up and get some formula. WIC is there to help mothers/parents who can not afford formula.

Oooh that just makes my blood boil--being a one time c-section Mom myself and a successful breastfeeder...cracked nipples go with the territory of ANY child birth experience (I had a VBAC with my second). It happens! Really do people think that child birth and rearing is a pain free experience?? It isn't.

I agree that formula companies are pushy and when hospitals and Docs give away free samples--they are in fact endorsing the formula as they way to feed your baby. In the back of my mind I wonder if they wish everyone formula feed because it's so much easier to measure intake with formula...they can see it in the bottle.

And on a side note--the fact that c-section rates are soaring should give us pause and to try to find out WHY and halt that upward swing, when the maker didn't give us zippers--why everyone seems to NEED a c-section.

This is a really interesting topic to me... it seems to be at the intersection of consumerism and breastfeeding. I'm 38 weeks into my pregnancy and I already have received 2 bags with formula, diaper coupons and samples, etc. Mostly stuff we are not planning on using since we really want to breast feed, use cloth diapers, and want to use more organic products, not the chemical-laden wipes and such. We're starting to get really annoyed by all the extra unsolicited "stuff" we keep getting. The worst has been going to the post office to get our mail, having a package pick-up slip in the box (and getting excited that it might be a present from a friend or something we actually ordered online), only to pick up the package and have it be more junk from a formula or diaper company. I know that if our hospital tries to send us home with yet another black bag with formula, we'll just say no.

I totally agree! If a mom is already bottle feeding in the hospital and has already chosen that route, offer them the formula bag or let them request it...but for moms who are breastfeeding don't give it to them unless they request it! I have breastfed 3 children. And let me tell you, especially with the first, having that formula sitting there in the corner of my room...at also at home was very tempting when things were not going so well. I can imagine that many breastfeeding relationships were given up on or unnecessarily disturbed by that formula that is given out. Who really wants to go to a store at 2am and get formula because your nipples hurt? But, if it's already there, it's just too tempting!!

And, what's more is that hospitals are more than happy to give out formula, but just go and ask them to include Breastfeeding pamphlets or info in their mother's kit. It's like pulling teeth in most hospitals. I never got 1 piece of info on Breastfeeding from the hospitals that I delivered at.And the nurses were not that helpful either.

I gave birth 3.5 months ago in San Antonio (and 2.5 years ago in Naperville, IL). When I was in the hospital, the nurse gave me my little black bag of formula. When I refused it explaining that my baby will only be BF she said, "Oh really? You don't look like the breastfeeding type" even though I had been breastfeeding since the instant I delivered my baby! I asked what the "BF type" was and she stammered to come up with an explanation for her stupid comment. I told her that all new moms are the "breastfeeding type" and that we all need encouragement, not samples of formula! I am 31 years old mother of two with a master's degree...that means I don't look like the type to breastfeed!? Or was it my brown hair that makes me the formula feeding type of mama?

What's ridiculous is that she says the samples are helpful for low-income moms. Which is actually not true, since the samples are the name-brands, not the cheaper generics. Moms think their doctors "recommend" the higher-priced samples, and stick with the brand, costing them hundreds more.

Better than handing a mom struggling to breastfeed a free can of formula would be to get a lactation consultant in there to help her, or to talk to the mother about donor milk if breastfeeding isn't working out. It saddens me to think that people will perservere through many of life's struggles but not when it comes to their children. Why is that?

Mothers need to be set up to succeed, not to fail. A person trying to lose weight doesn't buy a bunch of bags of potato chips to store in the cupboard tempting her to cheat on her diet - she avoids them so that she can reach her goal. Why is it such a stretch to do the same with formula?

I'm on the fence about this one. I do agree that having that ever-so-handy bag of formula sitting there when baby is crying and won't latch on and mom is just too damn tired to make it work can be the final nail in the coffin for breastfeeding. BUT, and this is a big BUT that definitely doesn't happen often....that formula can really come in handy for an emergency. I'm not talking about the situation the mom wrote about after her C-section. Oh, I might as well tell the story.

I suffered a cervical tear after my horrific 46-hour labor that went unnoticed until a week postpartum when I began to hemorrage. Baby and I were rushed to the ER, husband and friends close behind once they'd been called (I was home alone with baby and hubby was at work), and the whole world turned upside down while I bled to near-death waiting for the OR to open up so I could have a stitch placed on my cervix. Baby was crying, husband was frantic, I hadn't even packed a diaper bag or put clothes on the baby after I called 911 because I was so distraught, so hubby went home and threw a whole bunch of random things into a huge bag to take back to the hospital. One of them was that little black bag of formula. Like the mom whose story you shared, I had planned to breastfeed and didn't buy any formula prior to giving birth. But since I was being rushed around the hospital in a mad dash to discover what the source of my bleeding was and what could be done about it, there was no way I could have breastfed at that time, and my husband was so upset at the thought of his wife being so close to death that I'm pretty sure he wouldn't have had the sense to get himself to a store and buy formula for our child. Once the pre-made bottle had been placed in my son's mouth in the ER's waiting room, my husband and friends calmed down...at least one distressed person - the baby - was consoled for the time being, and that helped everyone else feel a little bit better.

I in no way advocate giving away formula at hospitals, and I feel that in most cases it definitely hinders what could be a promising breastfeeding relationship. But there's always that exception to the rule, and I guess this time, I was the exception. Would my baby have starved to death had I not been given that bag of formula? No. I'm sure SOMEONE would have gone to get some eventually. But it was there in a moment of crisis when we needed it.

My son and I went on to have a fabulous breastfeeding relationship that lasted a little over a year before we mutually decided to call it quits. :)

I totally agree that this article was full of misleading info- While I don't agree w/ breastfeeding moms being sent home with samples and find myself getting pissed when I get samples mailed to me (the kicker is when it's that extended formula for toddlers that has "significant ingredients found in breastmilk" but God forbid you nurse a toddler- that'd just be weird:-) ) But while I don't agree with it, I can very easily understand how a mother that did not nurse and only used formula could be on the other side of the issue. I agree, if your baby needs something you are not incapable of figuring out a way to get formula to your house-where there's a will there's a way- but I think that if you want formula from the hospital you should have access to it and if I had formula fed I could see myself thinking "what's the big deal- it's just samples". Now- I don't think that, but I hear horrible stories all the time about nurses that push breastfeeding so much to new moms that are not interested to the point of making them feel shameful and like horrible moms and I know that most all of us agree that that's not the way to make moms (or toddlers or anyone) want to do soemthing they don't wanna do. I think what would probably be the best way for nurses and hospitals to handle it (and maybe it's being done like this-i'm not sure) but for the staff to ask if you are planning on breastfeeding. If the answers yes- then great, don't offer them samples of formula that will go against waht they want for their children. If they answer no- or that they will be doing both- then ask them if they would like some samples of formula adn if they say yes then give it to them. This would seem pretty logical to me- but maybe this is how lots of places do it already- i'm not really sure....

My hospital is baby friendly and they don't give formula sample diaper bags at birth. I've had four kids and never received one. All of my kids were born via c-section, and I only had a little difficulty nursing my 36 week twins.

It's subtle but by handing these bags out to all new moms, formula feeding is the standard. I love that by not automatically distributing the bags, the paradigm shifts from all moms formula feed to all moms breastfeed.

My children were born 1 year and 21 days apart in the exact same hospital, with several familiar faces in the nursery staff and behind the OB nurses desk. I had the same doctor. I also received the "black bags" which became purses for my daughter and step daughter. The funny thing is that the first one had the free formula, some sample lotions,soaps, diaper rash cream, coupons for these items (not all the same brands) combs, and brushes. I used what I wanted, and disgarded the items I did not want. I was breastfeeding and later switched to formula, but chose a brand other than the free sample type. I did give away the free sample to an organization that could actually use it.The second bag I received contained the soaps and lotions and formula-which was a different brand than I had been given just a year before. This new bag also contained 3 small breast milk storage bottles, a small packet of milk storage bags, lanolin samples, breast pads, and some cold packs to be used in the bag which was lined to act as a cooler. So, although this bag was much more useful to me in terms of contents, it still had formula. I took the formula out and gave it to the nurse who had given me the bag, and explained that I would not be needing the sample. There was no controversey, no tears, just a simple "ok". I liked this change in "gift" bags. It is nice to get the free stuff, and I think that as long as nurses who hand them out are aware of who the recipient is, then there is not a big deal. It will always be expensive name-brand samples of everything, not just formula. The big companies have the money to spend on marketing. The companies who produce the generic stuff save money on marketing then seel their stuff cheaper. The most important thing a new mother can do is ask questions. If she wants to formula feed she can ask questions about types of formula. If she wants to breast feed she can ask questions about that. Hospitals tend to have lactation consultants to help out, but I am yet to meet a formula consultant, so maybe free samples are the best way to tackle that problem.

I see a very simple solution to this whole ordeal, similar to my own experience in the hospital with all 4 of my kids...

the nursery nurse comes in and says 'do you intend to breast or formula feed your baby?'

The mother responds with her decision.

Breastfeed? "We have a lactation consultant available for you to speak with, if you'd like. She can come and talk to you now if you like or she can come in and help you get the baby latched on when you're ready.'

Formula Feed? 'What type of formula did you want your baby to be fed? We have some samples available to get your through your first few days, if you'd like.'

And for the love of pete...if they want to give out free diaper bags they could at least make them so that they are breastfeeding or formula feeding bags. Obviously the formula bags would have samples of formula along with diapers, diaper rash creams and baby soap.

And breastfeeding diaper bags could have a manual pump, lanolin cream samples, nursing pads, numbers of local breastfeeding support groups and lactation consultants, websites and a book about breastfeeding. Oh, and something I think is pretty important now...something that specifically says 'if you have done your best and you still can not breast feed, for whatever reason...It's OK.'

Just make it so that it's a hospital regulation for the nurses to not be allowed to offer unsolicited advice to new mothers, about ANYTHING. Including epidurals, pitocin, feeding choices and circ choices. If they are asked then sure, let them give some helpful advice....and by advice I do not mean their opinion...I mean risks vs benefits of each option.

My question is this. If the hospitals are genuinely trying to be 'helpful' by providing formula samples to new moms, do they also provide other services or information that is helpful. For example, what if the woman is a single mother with no support system and happens not to have a partner to driver her home. (Rare I know, but so is inability to bf.) In this case does the hospital provide a car and driver to get her home? I didn't think so. There are just too many reasons why this is NOT about being helpful.

Maybe its just me..but the hospital I gave birth in had 2 diffrent types of these bags..one for moms that are breastfeeding and one for those that choose to use formula. I breast fed my daughter and got the one for breastfeeding which had a breast pump in it and other samples but did not have any formula. With my next son I tried to breast feed him but he refused so I got the one of each because I was trying to breast feed it just was not working out. I even had some formula at the house just in case! I still enjoyed getting the samples and used them until they were gone just so they would not go to waist! I did this with the next 2 as well. I feel this is the way all hospitals should do it! That way you don't get what you don't need!

"If they are asked then sure, let them give some helpful advice....and by advice I do not mean their opinion...I mean risks vs benefits of each option."

In a perfect world this would be the best thing to expect. Unfortunately, breastfeeding information is neither taught in medical school or nursing school. Meanwhile, formula reps make it a habit of taking LD nurses out to lunch and touting all the benefits of their particular brand. So what you end up with is many nurses (obviously not all!) who have a lot of opinions but very little evidence-based info to share.

actually i am hoping for some support/advice, i have a 7 1/2 month old who is nursing, she won't take a bottle, we gave up a while ago, this weekend we started trying the cup (had given every so often with water). we actually skipped a nursing session and tried the cup ....she took 2 ozs yesterday, not much today....i didn't pump as I really just want to replace a feeding and have it work....help - could you answer on my blog ?

I live in Australia and they aren't allowed to give Forumla samples in the baby bags they hand out. They have advertising in them but no free samples.

People know where to go here to get free samples if they want them. I am also someone who has had a c-section, my son only stopped breastfeeding last month(he turned 2 in March). I had cracked nipples and attachment issues as well.

I think there needs to be more breastfeeding support for mothers as I know from my own experience that because I had problems in hospital it didn't take much for them to be saying "How about we give him some formula". So it is easy to see why women ending up forumla feeding if they don't get support.

Eliat,I know that lactation is not taught in medical school, but I'm happy to say that I'm in RN school and we have a segment about breastfeeding while we are in our OB nursing class. I think it's a relatively new part of the curriculum, but I think it's a big step in the right direction. Maybe as the new new breastfeeding educated nurses enter the workforce and the older 'formula is best' nurses start to retire we will see a shift in support for breastfeeding mothers. The class really only teaches the basics, such as positioning the baby, how to tell if the baby is sucking effectively, how to educate mothers of frequency of feedings, basic physiology of lactation, etc... But even that little bit of education has really helped some of the students in the class that have no children or didn't breastfeed become more supportive of breastfeeding. In fact there are questions about breastfeeding on the NCLEX, which is our licensure test!

From Holly's comment: I read a post recently (it may have been one of yours), that said nurses get kickbacks for saying "this formula is the best".

This is absolutely false. The formula companies will give us, at most, a few breakfast pastries while they "inservice" us on their newer formulas and drugs (that's right - the formula companies are all pharmaceutical companies!). But never anything that could be considered a "kickback". The hospitals we work for have ethical codes and regulations in place to keep drug companies from bribbing us and our docs into using their products. And then there's our personal integrity. A stale cheese danish or a new pen isn't going to get me or most of the nurses I've worked with to recommend Similac over Enfamil, or formula feeding over breastfeeding.

The samples and bags aren't gifts. They are a marketing tool, and they aren't aimed at the nurses and the doctors - their aimed at the new parents.

Once again, I feel I need to come to the defense of the women of my profession.

First of all, breastfeeding is taught in nursing school. So is care of the woman in labor, the geriatric diabetic, the burn victim, the post-op bypass patient, how to screen a two year old for developmental delays, the pathophysiology of septic shock, and how care for a dead body.

My point is, we don't have the time to learn all the nuances of a breastfeeding family. That comes with experience on the mother/baby unit. And just because we're nurses doesn't make us lactation consultants. That requires extra experience and education.

I am really really sorry that we are getting such a negative representation. I'm not offended - just frustrated and sad. I care deeply about breastfeeding. All the nurses I've worked with - I've been a nurse for ten years and have worked for three different institutions - understand that breastfeeding is the gold standard. As for the "older nurses/formula is best" comment, everything I learned about breastfeeding my own children and helping moms to do the same, I learned from nurses with 20+ years of experience in mother/baby nursing. No matter their age, even if they don't care as much about breastfeeding, even if they didn't breastfeed their own children, no competent nurse will tell you formula is best. Melissa will learn, when she graduates, becomes licensed, and starts to practice, that the "older" nurses are have the wisdom and experience one cannot learn in school.

I know that this isn't what Jen's post started out as, but I see time and again on blogs and forums where people make nurses out to be the enemy. We're not. I promise you, with all my heart, we're not. Nursing is hard, dirty work. You have to be smart and think on your feet, literally. We're good people, and we love what we do. Unfortunately, we are also products of this American culture, which does not breastfeed, which shrugs off epidurals and c-sections as routine, which likes quick and easy solutions to any problem, not just an infant who won't nurse. We really care about you and your baby, and we want what's best for you both. Things have to change in our attitudes towards childbearing and breastfeeding as a culture for it to change one-on-one.

wlWell, in our local hospital, you get 2 black bags...one bottle feeding bag, and one breastfeeding bag.

The bottle feeding bag contains formula, coupons, a book on baby care (which discusses both types of feeding-more in depth on breast), small bottles of baby wash, lotion, wipes, diaper cream, a bulb syringe, hairbrush and comb, thermometer.

The breastfeeding bag (paid for by the formula company!!!) comes with cooler bags and freezer inserts, a manual pump, lanolin, breastpads, breast shells, a book on breastfeeding, a soft toy, a nice baby blanket, LLL info, lactation consultants info (on staff at the hospital), hospital nursery info (they encourage you to call anytime you have a question in the beginning).

Anyway, I love getting both! I donate the formula to our church to put in the food closet. I don't think that hospitals that give away the formula bags are un-baby friendly or un-breastfeeding friendly...I just think they need to look at BOTH sides of the feeding coin.

I'm glad that your hospital has guidelines in place and that you're able to see past the free treats to help your patients make good decisions.

Unfortunately, not every hospital is like that.

I have spoken with LCs that worked IN hospitals where formula companies actually sponsored "contests" among the nurse and ped staff to encourage use of their formula. Tanya has some stories on this over at the Motherwear blog.

There are also nurses out there that WILL be swayed by free Panera lunches a few times a week or by other "goodies" that are brought by pharm reps.

After all, if they didn't work, the companies would stop spending money on them.

This may not be a popular opinion...but free formula samples from the hospital got me through the first few days. Since I had every intention of bf'ing, I never thought to get formula or bottles 'just in case'. We were even fine the first day at home.

But, after DS was hospitalized for dehydration and subsequently forgot how to latch at all...I found myself at home alone, with a baby who wouldn't nurse, and terrified of him getting dehydrated again.

In retrospect, I probably shouldn't have been there all by myself--I'd hemorraghed, required emergency surgery, and bled enough to nearly require a transfusion. On top of that, because I had to take him back to the hospital, I literally hadn't slept for more than an hour at a time in a week. I was absolutely too weak to make it to the pharmacy or grocery store on the corner without help.

Yes, I was visited by the LC, and I was handed information about where to get help as well. The problem was...we went home for the second time on the weekend when the lactation center was closed. So while I was trying to get him to bf, crying every time, and thinking it was the longest weekend ever, I gave him those formula samples because I have no idea how I would have gotten to the store and back by myself. Looking back, I am sooo thankful those were sent home with me.

After a month of hard work, we were bf'ing with no problem. Going on seven months old now, and nursing several times a day. :)

So...long story short...I think both formula and lactaction information is the way to go.

What I didn't write about was the fact that a nurse at the hospital stuck a bottle of formula into my baby's mouth to "teach him to latch on", and I was so shocked that I let that nipple go into his mouth, saw him start to suck, and only then did it sink in "OMG get that the hell away from him!" I didn't write about staggering out of my hospital room one night when Izzy was not latching on and I was upset because every 3 hours or so a nurse would make her rounds and fill out this spreadsheet full of information about his diaper counts, about how many minutes he nursed at each side.. And apparently he was supposed to nurse like a pro on each side for 15 minutes at a time, x number of times per day. And he was supposed to have 6-8 dirty diapers per day... AND MY MILK HAD NOT YET COME IN.

Then there was the threat of keeping him in the hospital for jaundice... Which formula was supposedly the magic cure for..

Ugh.

Also, the bottles are conveniently labeled 'supplemental' formula. With literature on how to breastfeed... Provided by Similac. And it talked about how breast was best, but here's how you can mix breast/formula feeding... I nearly screamed. :p

And I still kept the blasted things around for 4 1/2 months before I could give them away.

I do not support those formula company bags... even the supposed "breastfeeding mothers" bag. It's all marketing. Don't let the formula company literature fool you...they say they know that breast is best...but by the way...so is our formula. When the formula reps come to the unit, I make a point to leave while they try to push new "data", pens, and snacks. Even if the breast feeding bags don't contain formula (they used to) they certainly have their brand logo all over it...in hopes that you go out and purchase their brand at 3AM to "calm" a crying baby who won't latch.

Anyhow... as a nurse...I could care less how you feed your baby. I'll assist with breast feeding or bottle feeding...I'm just happy the baby is getting fed.

I happen to think it's a cop-out for a woman who planned on breastfeeding was ruined by the evils of formula companies throwing samples at her. If you are breastfeeding - good for you just say no thanks to the bag. No need to waste everyone's time in meetings and letter writing campaigns to ban formula bags. I think the arguments I am reading around the net make it sound like women aren't smart enough to make a decision for themselves on how to feed their child - way to make us seem like victims without a voice. Even if the mother is tired after delivering her support team is there for a reason and they can say no-thanks. Also, if the hospital is jamming in your overnight bags which people are making it seem then donate them to a shelter or church.

Very interesting read. We stopped at in-laws and friends on our way home from the hospital - if we'd been bottle-feeding we'd have stopped for formula too. If I'd had a C-section I'd have waited a minute in the car for the driver (in this case my husband) to go in and get some and foregone the visits. I'm just saying, there are exceptions, but why did this woman think that it had to be free from the hospital or she couldn't have gotten it on the way home? And why the feeling of entitlement?

I gave birth about 20 years ago and remember being thrilled to find out that we were allowed to take things home from the bassinet - the wipes we were using, the open pack of diapers, the breast pads, the pack of bottles "for emergency" they kept underneath - because we really were broke and gifts were wonderful. It would never have occurred to me to think that the hospital owed it to me to give me gifts, seriously, and they didn't give me any black bag. We did use those bottles in the first few weeks, though I did nurse for several months.

"With Caesarean rates skyrocketing in New York City (some hospitals have a nearly 40 percent rate of Caesarean delivery), formula often becomes a necessary part of the equation."

Well, I can understand (especially with the intense cramps I had nursing my second child - "afterlabor" they called it) combined with the intense pain of surgery why it could be extremely painful, I really don't think "necessary part of the equation" is necessarily necessary.

Is anyone else squicked out that she seems far less concerned by the obviously HUGE problem that there are "skyrocketing C-sections" than whether mom gets freebies? "I'll take the black bag and the dangerous major surgery please." Does she realize that in most cases birth and feeding are natural processes that don't require major intervention such as, you know, cutting a woman open stem to stern and mixing chemicals in a laboratory to feed the offspring? I'm sorry, but I'm VERY worried to hear that C-sections are STILL skyrocketing; I honestly thought we'd advanced as a society into the wisdom of the ages with more midwivery (such as in countries where it's normal and they have a far lower rate of infant mortality) and medical intervention only when truly necessary. No way is it necessary in anything near 40% or 30% or 20% or even fewer births. I think in this particular case the lack of knowledge is disturbing.

"Whether bottle-feeding is voluntary or has been dictated by circumstance, neither the government nor the medical establishment should try to manipulate a woman's decision by withholding samples that formula manufacturers are more than happy to provide."

Not that anyone's trying to "withhold" it, so cry me a river. But manipulated? Yes you're being manipulated, by pushy advertising. I know some women are nowadays pushed hard into nursing, but it was very different years ago, and the nurses really did lack an adequate knowledge of nursing, and there weren't lactation consultants in the OB wards to help us out.

I just don't get why they can't simply tell the mom that there are bags containing sample formula, wipes, blah blah, if they want it. This woman seems to feel offended by that, that entitlement thing again. How annoying.

I also don't get with all the lactation support available now (I truly did get some horrendous nursing advice when I gave birth, as well as having nurses trying very hard to take my baby away immediately after feeding...even getting angry when I asked "Can't she stay?" and answering, "She's not HUNGRY!" Heh, at my puzzled look the very kind young nurse who knew what I'd already been through, complications, etc, saw my stricken look and waved the other nurse to let the baby stay with me and be quiet. Fortunately the second birth hospital was much more family friendly; their nurses were much more busy and appreciated the parents taking care of them in the daytime. Still bad nursing advice though.)

If companies are happy pimping their products, hospitals could of course offer nursing bags or formula bags and the nurse could just ask which one. Not a big deal. Certainly nothing for people to get mad about or talk of "banning" when that's not what's happening. On that note I have read some nursing activists who really would ban all formula samples in hospitals, and while I agree with them that marketing should be less aggressive, I see no reason someone who's definitely going to bottle feed shouldn't get a sample the company wants to give away. We have the brains to buy the generic when we get home if we can't afford the brands anyway, and every little bit helps.

With the birth of the youngest (VBAC), I took the bag b/c there was no label on the outside but I left the cans sitting on the hospital counter. When I told my OB's nurse "no thanks" to the freebies she was passing out, she was completely confused, even *after* my attempts to explain.

Alena - I like the cigarette analogy!

Danielle - yes, this is what I have done with the cans I receive in the mail.

Did you all know (probably did) that when you indicate your intent to breastfeed you get sent a *bigger* free formula can than a mom who plans on formula feeding?

Birdwell - we aren't made with a zipper, I love it!

Crystal - great analogy to weight loss!

not organized - love the term "paradigm shift" here.

melissa - great news, that does seem to cover the basics fairly comprehensively!

erin - well said, thanks for chiming in.

lil - I could have written your comment. I have to fight tears thinking about it.

{{{HUGS}}} all around, it's an important discussion to have, and thanks to Jenn for hosting it.

"Perfectly measured samples"? A newborn does not need to eat 4 oz at one time! I am a nurse on a pediatric floor, and I'm known as the go-to person for breastfeeding questions. And I know how to set up the breast pump. The samples aren't "free;" they're marketing. And new mothers are very highly susceptible to such advertising. I planned to breastfeed, but I kept all those samples on a shelf in the garage until little boy was a year old, just in case. Then I donated all my "free" formula samples to the food bank at church. (They were nowhere near expiration.) I've often wondered why "free" diaper bags aren't sponsored by, I don't know, _diaper_ manufacturers.

I am a Registered Dietitian and pro-breastfeeding. I am also a formula representative. Have you guys ever thought that the formula companies are competing against each other and not against breastmilk? I am dedicated to an infant's nutrition, and if a mom is going to formula feed, they should know the benefits of a particular formula through their healthcare provider.